1
|
Mazza M, Lisci FM, Marzo EM, De Masi V, Abate F, Marano G. Why Do They Do It? The Psychology Behind Antisocial Behavior in Children and Adolescents. Pediatr Rep 2025; 17:26. [PMID: 40126225 PMCID: PMC11932266 DOI: 10.3390/pediatric17020026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2025] [Revised: 02/19/2025] [Accepted: 02/20/2025] [Indexed: 03/25/2025] Open
Abstract
Antisocial Personality Disorder (ASPD) is a complex and often debilitating condition that can emerge from early behavioral disturbances in childhood and adolescence. This narrative review provides a comprehensive overview of the current understanding of ASPD in pediatric and adolescent populations, examining key diagnostic challenges, developmental trajectories, and emerging treatment approaches. Recent research underscores the critical role of the early identification of conduct disorder (CD) and oppositional defiant disorder (ODD) as precursors to ASPD. Specific attention is given to biological, environmental, and psychosocial risk factors, including genetic predispositions, family dynamics, and socio-economic adversity. Additionally, neuro-psychological research highlights deficits in executive function, emotion regulation, and social cognition, which may underline the persistent antisocial patterns. Neuroimaging studies suggest atypical neural activity in regions associated with empathy, reward processing, and impulse control. Effective intervention remains a challenge, as treatment options are limited and often complicated by co-occurring conditions, such as attention deficit hyperactivity disorder (ADHD) and mood disorders. Promising evidence supports the efficacy of integrative, multimodal approaches combining behavioral therapy, family interventions, and pharmacotherapy to reduce symptom severity and improve long-term outcomes. The review concludes by advocating for a public health approach that emphasizes prevention and early intervention, aiming to mitigate the progression to full ASPD in adulthood.
Collapse
Affiliation(s)
- Marianna Mazza
- Unit of Psychiatry, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy; (F.M.L.); (E.M.M.); (V.D.M.); (F.A.); (G.M.)
- Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Francesco Maria Lisci
- Unit of Psychiatry, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy; (F.M.L.); (E.M.M.); (V.D.M.); (F.A.); (G.M.)
- Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Ester Maria Marzo
- Unit of Psychiatry, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy; (F.M.L.); (E.M.M.); (V.D.M.); (F.A.); (G.M.)
- Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Valeria De Masi
- Unit of Psychiatry, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy; (F.M.L.); (E.M.M.); (V.D.M.); (F.A.); (G.M.)
- Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Francesca Abate
- Unit of Psychiatry, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy; (F.M.L.); (E.M.M.); (V.D.M.); (F.A.); (G.M.)
- Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giuseppe Marano
- Unit of Psychiatry, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy; (F.M.L.); (E.M.M.); (V.D.M.); (F.A.); (G.M.)
- Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| |
Collapse
|
2
|
Kanarik M, Sakala K, Matrov D, Kaart T, Roy A, Ziegler GC, Veidebaum T, Lesch KP, Harro J. MAOA methylation is associated with impulsive and antisocial behaviour: dependence on allelic variation, family environment and diet. J Neural Transm (Vienna) 2024; 131:59-71. [PMID: 37507512 DOI: 10.1007/s00702-023-02675-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023]
Abstract
Congenital absence of monoamine oxidase A (MAO-A) activity predisposes to antisocial impulsive behaviour, and the MAOA uVNTR low-expressing genotype (MAOA-L) together with childhood maltreatment is associated with similar phenotypes in males. A possible explanation of how family environment may lead to such behaviour involves DNA methylation. We have assessed MAOA methylation and impulsive/antisocial behaviour in 121 males from the Estonian Children Personality Behaviour and Health Study. Of the 12 CpG sites measured, methylation levels at the locus designated CpG3 were significantly lower in subjects with antisocial behaviour involving police contact. CpG3 methylation was lower in subjects with alcohol use disorder by age 25, but only in MAOA-H genotype. No correlation between MAOA CpG3 methylation levels and adaptive impulsivity was found at age 15, but in MAOA-L genotype a positive correlation appeared by age 18. By age 25, this positive correlation was no longer observed in subjects with better family relationships but had increased further with experience of adversity within the family. MAOA CpG3 methylation had different developmental dynamics in relation to maladaptive impulsivity. At age 18, a positive correlation was observed in MAOA-L genotype with inferior family relationships and a negative correlation was found in MAOA-H with superior home environment; both of these associations had disappeared by age 25. CpG3 methylation was associated with dietary intake of several micronutrients, most notable was a negative correlation with the intake of zinc, but also with calcium, potassium and vitamin E; a positive correlation was found with intake of phosphorus. In conclusion, MAOA CpG3 methylation is related to both maladaptive and adaptive impulsivity in adolescence in MAOA-L males from adverse home environment. By young adulthood, this relationship with maladaptive impulsivity had disappeared but with adaptive impulsivity strengthened. Thus, MAOA CpG3 methylation may serve as a marker for adaptive developmental neuroplasticity in MAOA-L genotype. The mechanisms involved may include dietary factors.
Collapse
Affiliation(s)
- Margus Kanarik
- Division of Neuropsychopharmacology, Institute of Chemistry, Faculty of Science and Technology, University of Tartu, Ravila 14A Chemicum, 50411, Tartu, Estonia
| | - Katre Sakala
- National Institute for Health Development, Tallinn, Estonia
- School of Natural Sciences and Health, Tallinn University, Tallinn, Estonia
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Denis Matrov
- Section on Behavioral Neuroscience, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Tanel Kaart
- Institute of Veterinary Medicine and Animal Science, Estonian University of Life Sciences, Tartu, Estonia
| | - Arunima Roy
- Division of Molecular Psychiatry, Center of Mental Health, University Hospital Würzburg, Würzburg, Germany
| | - Georg C Ziegler
- Division of Molecular Psychiatry, Center of Mental Health, University Hospital Würzburg, Würzburg, Germany
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
| | | | - Klaus-Peter Lesch
- Division of Molecular Psychiatry, Center of Mental Health, University Hospital Würzburg, Würzburg, Germany
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, The Netherlands
| | - Jaanus Harro
- Division of Neuropsychopharmacology, Institute of Chemistry, Faculty of Science and Technology, University of Tartu, Ravila 14A Chemicum, 50411, Tartu, Estonia.
| |
Collapse
|
3
|
Saputra F, Uthis P, Sukratul S. Conduct problems among middle adolescents in the community settings: A concept analysis. BELITUNG NURSING JOURNAL 2023; 9:293-301. [PMID: 37645575 PMCID: PMC10461166 DOI: 10.33546/bnj.2670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/07/2023] [Accepted: 07/04/2023] [Indexed: 08/31/2023] Open
Abstract
Background Adolescent problem behavior in research and practice has been traditionally categorized as Oppositional Deviant Disorder and Conduct Disorder. However, a significant number of adolescents remain underdiagnosed. To address this issue, the term "Conduct Problem" has emerged as a commonly used descriptor for those who have not yet received a formal diagnosis, particularly within the community. It is crucial for nurses to comprehend the characteristics of these conduct problems to address them effectively. Objective This concept analysis aimed to clarify the concept of conduct problems among adolescents aged 14 to 16, specifically within community settings. Methods The concept analysis followed Walker and Avant's approach. The usage of the concept was examined in five databases (PsyINFO, ProQuest, PubMed, ScienceDirect, Scopus), which yielded 41 relevant studies for comprehensive analysis. Results The identified attributes of conduct problems in adolescents included oppositional problems, antisocial problems, and criminal-related problems. These conduct problems were found to have antecedents stemming from personal, parental, and environmental factors. Furthermore, the consequences of conduct problems significantly impacted both middle adolescents and their parents. Conclusion The findings of this concept analysis contribute to a better comprehension of the concept of conduct problems among middle adolescents in community settings. The insights gained from this analysis will assist in using this term more effectively in research and nursing practice, ultimately leading to improved care and support for affected adolescents and their families.
Collapse
Affiliation(s)
- Fauzan Saputra
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
| | - Penpaktr Uthis
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
| | - Sunisa Sukratul
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
| |
Collapse
|
4
|
Sakala K, Katus U, Kiive E, Veidebaum T, Harro J. Is low platelet MAO activity associated with antisocial behavior? evidence from representative samples of longitudinally observed birth cohorts. Brain Res 2023; 1804:148249. [PMID: 36682705 DOI: 10.1016/j.brainres.2023.148249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/09/2023] [Accepted: 01/17/2023] [Indexed: 01/21/2023]
Abstract
Lower platelet monoamine oxidase (MAO) activity has been associated with problem behaviors, including criminal behavior, but not all studies agree. We have examined platelet MAO activity and antisocial behavior involving police contact in a longitudinal birth cohort study. The sample included both birth cohorts (original n = 1238) of the Estonian Children Personality Behavior and Health Study. Platelet MAO activity was measured at ages 15, 18 and 25 radioenzymatically with β-phenylethylamine as the substrate. Police contacts were self-reported in an interview and drug use in a questionnaire filled in during a laboratory visit. In cross-sectional analyses, males with the record of antisocial behavior had lower platelet MAO activity. In longitudinal mixed-effect regression models, this association was found to be independent of smoking. Furthermore, including smoking in the model revealed lower platelet MAO activity also in females with past antisocial behaviour. A further exploratory regression analysis with antisocial behavior at two levels of frequency and consideration of self-reported use of illicit drugs either in a single occasion or repeatedly demonstrated some "dose-dependency" in the relationship of antisocial behavior and platelet MAO activity. Platelet MAO activity was lower in male but not female subjects with basic education level as compared to secondary and higher education, but it was not related to non-verbal intelligence. Neither was platelet MAO activity associated with socio- economic status. In conclusion, antisocial behavior as occurring in general population is associated with low platelet MAO activity that probably reflects low capacity of the serotonergic system.
Collapse
Affiliation(s)
- Katre Sakala
- Department of Family Medicine and Public Health, Faculty of Medicine, University of Tartu, Estonia; Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia; School of Natural Sciences and Health, Tallinn University, Tallinn, Estonia
| | - Urmeli Katus
- Department of Family Medicine and Public Health, Faculty of Medicine, University of Tartu, Estonia
| | - Evelyn Kiive
- Division of Special Education, Department of Education, University of Tartu, Estonia
| | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | - Jaanus Harro
- School of Natural Sciences and Health, Tallinn University, Tallinn, Estonia; Chair of Neuropsychopharmacology, Institute of Chemistry, University of Tartu, Tartu, Estonia.
| |
Collapse
|